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General NPI Number Information
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NPI Number | 1356838734
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Entity Type | Organization
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Legal Business Name | JACLYN HARRISON, MD, PLLC
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 7580 FANNIN ST STE 303
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City | HOUSTON
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State | TX
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Zip | 77054-1940
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Country | US
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Telephone | 713-714-5376
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Fax | 281-815-4372
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Provider Business Mailing Address
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Address Line | 448 W 19TH ST # 581
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City | HOUSTON
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State | TX
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Zip | 77008-3914
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Country | US
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Telephone | 713-714-5376
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Fax | 281-815-4372
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Authorized Official
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Title or Position | DOCTOR
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Name | JACLYN HARRISON
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Credential | MD
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Telephone | 713-714-5376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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